This proposal presents a comparative study of three systems of care for severely emotionally disturbed children and adolescents. There is growing concern that the pattern of treating youth in costly, restrictive environments may be clinically inappropriate and fiscally insupportable. Little is known about the diagnostic profile of these youth and the range of human service needs they experience. The study addresses the effect of an innovative approach to service delivery and financing involving interagency coordination and integration within three public systems of care. It is butt upon an existing research contract with the California Department of Mental Health to monitor, verify, and evaluate the implementation of the Ventura model in three California counties. The research proposed here will also measure the clinical prevalence, incidence and distributions of mental disorders among youth in the major public service sectors (Mental Health, Social Welfare, Juvenile Justice, Public Health and Education). Of special interest are the relationships of age, gender, ethnicity, socio-economic status, and diagnosis to service use, costs of care, and clinical outcomes. The design allows a cost effectiveness comparison of the model care system in various phases of its implementation across counties and sectors. The research seeks to identify important system and client variables that account for costs of care and service use and to study shifts in the relative importance oil those variables over time and system change. Data regarding patterns of service use and costs of care wt be collected at the individual proband level. Clinical profiles of youth will be developed using standardized instruments, including the Diagnostic Interview Schedule for Children, and the Child Behavior Checklist, among others. The project involves public sector professionals and leaders in the child area as co-investigators and collaborators at the state and county level, in a manner that complements the goals of the Federal and State CASSP program. Finally, the study is conducted under the auspices of the Institute for Mental Health Services Research and its Center for Research on the Organization and Financing of Care for the Severely Mentally Ill.